EDITORIAL

Medicaid for Mom

5/20/2013

Mother's Day is over for the year, but the health-care needs of working-class Ohio mothers and their children remain acute. State lawmakers should address these needs promptly, not shove them aside for another year — or forever.M

The Republican-dominated General Assembly continues to ignore GOP Gov. John Kasich’s plea to expand Ohio’s Medicaid program of health insurance for low-income and disabled people. Mr. Kasich’s expansion plan would reduce medical costs borne by taxpayers, employers, and people with private insurance. Its emphasis on preventive care would improve public health, strengthening families and communities.

Expansion would create jobs, generate new tax revenue and economic activity, and save state government lots of money. It would upgrade local mental-health and substance abuse programs. And it would be funded almost completely by Washington under the federal Affordable Care Act, also known as Obamacare.

The plan would provide coverage to 275,000 Ohioans almost immediately, and to 456,000 over the next decade, including 25,000 Lucas County residents. A new analysis by the liberal advocacy group Policy Matters Ohio shows how it would especially benefit mothers who work for low pay and no benefits.

Policy Matters estimates that the proposed expansion would include more than 153,000 women — a large number of them working mothers — between the ages of 19 and 44. Many of them work for wages that are too low to allow them to buy private health insurance, but too high to qualify them for Medicaid, even under Obamacare’s other reforms.

Perversely, getting a raise or more work hours might help lift some of these women out of poverty. But it could also cost them the bare-bones coverage they have now.

The advocacy group plausibly links these women’s lack of health coverage to Ohio’s infant-mortality rate of nearly eight deaths in the first year of life per 1,000 live births — the 11th highest rate in the nation. Worse, among African-Americans in Ohio, the infant death rate is twice as high as the statewide average, and in some counties is even worse.

Medical evidence is clear: Women who have health insurance during pregnancy deliver healthier babies, because they are more likely to get prenatal care. The Medicaid expansion would broaden access to such care, reducing infant deaths and expensive premature births.

Yet the Republican majorities in the state House and Senate remain unmoved by such compelling data. Their opposition to Medicaid expansion is rooted less in sound policy than in partisan politics — an effort to placate the hard-right, anti-Obamacare zealots who could exert disproportionate influence in the GOP primaries many lawmakers may face next year.

Republican legislative leaders say they want to “study” the Medicaid program and and unrelated welfare issues, and suggest “reforms” at some future time — an obvious smoke screen for doing nothing. Do they truly believe that the Kasich administration’s Office of Health Transformation, which oversees the program, is tolerating widespread Medicaid waste, fraud, and abuse?

To the contrary, administration officials note that federal regulators called Ohio’s Medicaid fraud control unit the nation’s best in 2011. Last year, Ohio’s program led the nation in Medicaid fraud indictments and ranked third among the states in convictions.

It’s among the leaders in conducting audits that identify overpayments and lead to recoveries. The new state budget bill includes even more money-saving Medicaid reforms. So the “fraud” dog won’t hunt.

Hospitals, doctors, nursing homes, business lobbies, unions, and advocacy groups across the ideological spectrum support Medicaid expansion in Ohio. So does a plurality of Ohioans, according to opinion polls.

Republican lawmakers can offer all the excuses they want for their feckless obstructionism in resisting Medicaid expansion. But they can’t argue persuasively that they’re acting in the best interests of the state and its taxpayers.

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